Provider Demographics
NPI:1528270709
Name:KOFSKY, STUART ABRAHAM (DDS)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:ABRAHAM
Last Name:KOFSKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 NOXON RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3755
Mailing Address - Country:US
Mailing Address - Phone:845-452-8896
Mailing Address - Fax:845-485-6310
Practice Address - Street 1:452 NOXON RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-3755
Practice Address - Country:US
Practice Address - Phone:845-452-8896
Practice Address - Fax:845-485-6310
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039143122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist